Pub Date : 2022-11-01DOI: 10.21608/ebwhj.2022.159000.1198
Shaema Elshemy, A. Magdy, Amr Mallawany, Sherif Zaky
Background: Prolonged labor can lead to increased maternal and neonatal morbidity and mortality. The two main factors that determine duration of labor are cervical dilatation and effacement . Several studies showed that active management of labor could shorten the duration of labor through mechanical, pharmacological and non-pharmacological factors that can increase cervical dilatation. Metoclopramide could reduce spasms of the smooth muscle of the cervix , has a regulatory effect on cervical contractility and promoting cervical dilatation during labor. Objective: To determine whether Metoclopramide shortens the active phase of first stage of labor in Nulliparous women at term and reduces pain during this stage or not. Subject and Methods: A controlled, clinical trial between March 2022 to July 2022 was conducted, including a total of 100 pregnant women in active labor , they were randomly assigned into 2 groups; 50 women received an intravenous injection of 10 mg metoclopramide (Group 1) and 50 women received the same volume of placebo (0.9% sodium chloride) (Group 2). 2 (P- value < 0.001). The mean rate of cervical dilatation was 2.03 (cm/h) in group1 compared to 1.1(cm/h) in group 2. 19/50 (38%) women of group 1 needed oxytocin augmentation, while 35/50 (70%) women of group 2 needed oxytocin augmentation , which was highly statistically significant ( P-value <0.001). Regarding labor pain score using baseline visual analogue scale (VAS) and at 30, 60 and 120 minutes, the differences between both groups were not statistically significant ( P-value >0.001). Conclusion: This study showed that IV injection of Metoclopramide 10 mg every 2 hrs for a maximum of three doses help in reducing duration of active phase of first stage of labor with reducing the use of oxytocin in augmentation of labor.
{"title":"The Effect of Metoclopramide on the Length of First Stage of Labor and on Labor Pain in Nulliparous Women, A Randomized Controlled Trial","authors":"Shaema Elshemy, A. Magdy, Amr Mallawany, Sherif Zaky","doi":"10.21608/ebwhj.2022.159000.1198","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.159000.1198","url":null,"abstract":"Background: Prolonged labor can lead to increased maternal and neonatal morbidity and mortality. The two main factors that determine duration of labor are cervical dilatation and effacement . Several studies showed that active management of labor could shorten the duration of labor through mechanical, pharmacological and non-pharmacological factors that can increase cervical dilatation. Metoclopramide could reduce spasms of the smooth muscle of the cervix , has a regulatory effect on cervical contractility and promoting cervical dilatation during labor. Objective: To determine whether Metoclopramide shortens the active phase of first stage of labor in Nulliparous women at term and reduces pain during this stage or not. Subject and Methods: A controlled, clinical trial between March 2022 to July 2022 was conducted, including a total of 100 pregnant women in active labor , they were randomly assigned into 2 groups; 50 women received an intravenous injection of 10 mg metoclopramide (Group 1) and 50 women received the same volume of placebo (0.9% sodium chloride) (Group 2). 2 (P- value < 0.001). The mean rate of cervical dilatation was 2.03 (cm/h) in group1 compared to 1.1(cm/h) in group 2. 19/50 (38%) women of group 1 needed oxytocin augmentation, while 35/50 (70%) women of group 2 needed oxytocin augmentation , which was highly statistically significant ( P-value <0.001). Regarding labor pain score using baseline visual analogue scale (VAS) and at 30, 60 and 120 minutes, the differences between both groups were not statistically significant ( P-value >0.001). Conclusion: This study showed that IV injection of Metoclopramide 10 mg every 2 hrs for a maximum of three doses help in reducing duration of active phase of first stage of labor with reducing the use of oxytocin in augmentation of labor.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89728570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.21608/ebwhj.2022.163887.1202
Mohamed Etman, Sara Abdel Azeem, Abd El-Samie Abd El-Samie, M. Bakry
{"title":"Uterine Niche and Secondary Infertility: Agreement in Diagnosis Using Hysterosalpingography vs. Hydrosonography","authors":"Mohamed Etman, Sara Abdel Azeem, Abd El-Samie Abd El-Samie, M. Bakry","doi":"10.21608/ebwhj.2022.163887.1202","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.163887.1202","url":null,"abstract":"","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78797341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.21608/ebwhj.2022.163890.1203
A. Dawood, A. Soliman, Sherif Elshwaikh, A. Elkhyat
Objective: To compare the efficacy and safety of ERTT to cerclage in triplet pregnancy. Material and Methods: In this retrospective study, files of 266 patients were examined. Eligible patients managed by ERTT (n=120) were allocated into study group while patients managed by cerclage (n=121) were allocated into control group. Embryo reduction was done by oocyte aspiration needle before 10 th week. Cerclage was done at 14-16 weeks. Obstetrical and neonatal adverse outcomes were assessed in both groups. Results: One hundred and twenty cases were allocated in cerclage (control) group, 121 cases were allocated in ERTT (study) group. There was significant difference between both groups regarding abortion rate ( P-value =0.002), delivery time ( P-value =0.0001), gestational age at time of delivery (P-value=0.0001) and mode of delivery ( P-value =0.0002). There was significant difference between both groups regarding fetal birth weight ( P-value =0.0002), overall neonatal complications ( P value 0.009) and need of NICU ( P=value 0.0003). Conclusion: Embryo reduction to twins (ERTT) procedures improved obstetrical and neonatal outcomes in triplet pregnancies compared to conservative management with cerclage procedure.
{"title":"Embryo Reduction to Twins (ERTT) Versus Cerclage in Triplets in Women with Normal Cervical Parameters: A Retrospective Study","authors":"A. Dawood, A. Soliman, Sherif Elshwaikh, A. Elkhyat","doi":"10.21608/ebwhj.2022.163890.1203","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.163890.1203","url":null,"abstract":"Objective: To compare the efficacy and safety of ERTT to cerclage in triplet pregnancy. Material and Methods: In this retrospective study, files of 266 patients were examined. Eligible patients managed by ERTT (n=120) were allocated into study group while patients managed by cerclage (n=121) were allocated into control group. Embryo reduction was done by oocyte aspiration needle before 10 th week. Cerclage was done at 14-16 weeks. Obstetrical and neonatal adverse outcomes were assessed in both groups. Results: One hundred and twenty cases were allocated in cerclage (control) group, 121 cases were allocated in ERTT (study) group. There was significant difference between both groups regarding abortion rate ( P-value =0.002), delivery time ( P-value =0.0001), gestational age at time of delivery (P-value=0.0001) and mode of delivery ( P-value =0.0002). There was significant difference between both groups regarding fetal birth weight ( P-value =0.0002), overall neonatal complications ( P value 0.009) and need of NICU ( P=value 0.0003). Conclusion: Embryo reduction to twins (ERTT) procedures improved obstetrical and neonatal outcomes in triplet pregnancies compared to conservative management with cerclage procedure.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87553075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.21608/ebwhj.2022.158989.1197
I. Souidan, Hatem Abdel Salam
Background: Intrauterine growth restriction(IUGR) has been defined as the rate of fetal growth that is below normal in light of the growth potential of a specific infant as per the race and gender of the fetus. A woman with a prior pregnancy complicated by IUGR has nearly a 20% risk of recurrence. Defects in placental vascular development can cause embryonic death, can negatively affect fetal growth and can confer a higher risk of disease in the postnatal life. Objective: study aimed to assess the role of first trimester uterine artery Doppler pulsatility index, placental volume and placental vascularization assessed in prediction of recurrence of third trimester intrauterine growth restriction. Methods: In this Prospective longitudinal observational study,two hundred pregnant women with singleton pregnancy from 11 up to 13 weeks with history of intrauterine growth restriction in a previous pregnancy underwent ultrasound assessment of gestational age, ultrasound assessment of uterine artery pulsatility index, placental volume by 3D ultrasound and placental vascularization by 3D power Doppler (3DPD). Results: Placental volume, vascularization index, flow index(F.I), vascularization flow index, and Uterine artery pulsatility index were significantly lower in IUGR with PET(pre eclampatic toxemia) group and IUGRgroup versus normal group, ( p-value <0.001).Further, placental volume and F.I were significantly lower in IUGR and PET group compared to IUGR only group. Conclusions: The 1st trimester placental volume, uterine artery Doppler, and, placental vascular indices are useful parameters for prediction of recurrence of IUGR. to assess the role of first trimester Doppler and vascularization in the prediction of recurrence of third trimester intrauterine growth restriction
{"title":"US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study","authors":"I. Souidan, Hatem Abdel Salam","doi":"10.21608/ebwhj.2022.158989.1197","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.158989.1197","url":null,"abstract":"Background: Intrauterine growth restriction(IUGR) has been defined as the rate of fetal growth that is below normal in light of the growth potential of a specific infant as per the race and gender of the fetus. A woman with a prior pregnancy complicated by IUGR has nearly a 20% risk of recurrence. Defects in placental vascular development can cause embryonic death, can negatively affect fetal growth and can confer a higher risk of disease in the postnatal life. Objective: study aimed to assess the role of first trimester uterine artery Doppler pulsatility index, placental volume and placental vascularization assessed in prediction of recurrence of third trimester intrauterine growth restriction. Methods: In this Prospective longitudinal observational study,two hundred pregnant women with singleton pregnancy from 11 up to 13 weeks with history of intrauterine growth restriction in a previous pregnancy underwent ultrasound assessment of gestational age, ultrasound assessment of uterine artery pulsatility index, placental volume by 3D ultrasound and placental vascularization by 3D power Doppler (3DPD). Results: Placental volume, vascularization index, flow index(F.I), vascularization flow index, and Uterine artery pulsatility index were significantly lower in IUGR with PET(pre eclampatic toxemia) group and IUGRgroup versus normal group, ( p-value <0.001).Further, placental volume and F.I were significantly lower in IUGR and PET group compared to IUGR only group. Conclusions: The 1st trimester placental volume, uterine artery Doppler, and, placental vascular indices are useful parameters for prediction of recurrence of IUGR. to assess the role of first trimester Doppler and vascularization in the prediction of recurrence of third trimester intrauterine growth restriction","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85575849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.141262.1178
M. Elsersy
Aim: Asses the effectiveness of three steps resection method of an isthmocele using hysteroscopy in patients complained of postmenstrual bleeding with confirmed presence of isthmocele. Study Design: Prospective interventional cohort study. Materials and Methods: 50 patients complained of postmenstrual bleeding with confirmed presence of an isthmocele. After written consent, the patients have been subjected to three steps hysteroscopic resection of an isthmocele by removing the distal edge of the niche then the proximal edge and lastly ball cauterization of the floor of the pouch of the isthmocele. Postoperative transvaginal ultrasound and follow up for 2 menstrual cycles were performed for all patients. Results: The median duration of menstruation shortened from 13 days to 7days after surgery ( p < 0.01). The median duration of postmenstrual spotting improved from 6 days (range 5-7 days) to 2 day (range 0–3 days) at follow-up ( p < 0.01). Follow up transvaginal ultrasound showed significant reduction of the niche depth from 5.2±1.1 mm to 2.3±1.3 ( p < 0.01). Conclusion: Hysteroscopic repair of post caesarean isthmocele in patients with post menstrual spotting is considered an effectiveness minimally invasive choice of treatment.
{"title":"Effectiveness of Three Steps Hysteroscopic Repair of Isthmocele in Patients with Post Menstrual Spotting","authors":"M. Elsersy","doi":"10.21608/ebwhj.2022.141262.1178","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.141262.1178","url":null,"abstract":"Aim: Asses the effectiveness of three steps resection method of an isthmocele using hysteroscopy in patients complained of postmenstrual bleeding with confirmed presence of isthmocele. Study Design: Prospective interventional cohort study. Materials and Methods: 50 patients complained of postmenstrual bleeding with confirmed presence of an isthmocele. After written consent, the patients have been subjected to three steps hysteroscopic resection of an isthmocele by removing the distal edge of the niche then the proximal edge and lastly ball cauterization of the floor of the pouch of the isthmocele. Postoperative transvaginal ultrasound and follow up for 2 menstrual cycles were performed for all patients. Results: The median duration of menstruation shortened from 13 days to 7days after surgery ( p < 0.01). The median duration of postmenstrual spotting improved from 6 days (range 5-7 days) to 2 day (range 0–3 days) at follow-up ( p < 0.01). Follow up transvaginal ultrasound showed significant reduction of the niche depth from 5.2±1.1 mm to 2.3±1.3 ( p < 0.01). Conclusion: Hysteroscopic repair of post caesarean isthmocele in patients with post menstrual spotting is considered an effectiveness minimally invasive choice of treatment.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73457742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.58189.1118
A. el-habashy
Aim: Evaluation of the role of head progression distance (PD) using the transperineal ultrasound (TPUS) in assessment of progress of labor. Materials and Methods: This study conducted on 60 cases admitted to El-Shatby Maternity University Hospital in active phase of labor, at full term with singleton pregnancy presented by vertex. We measured the head progression distance (PD) in each case on admission, after 1 hour and after 2 hours (using transperineal ultrasound) and correlated it with the Bishop score by digital examination. We documented also the mode of delivery in all cases. Results: The mean head progression distance (PD) had a statistically significant association with the fetal head station on admission, after 1 hour and after 2 hours. HPD will get longer with the progress of labor with the fetal head descent. The sensitivity of Bishop score on admission to predict the mode of delivery was 58.33% at cut-off 7, after 1 hour it was 75% at cut-off 9 and after 2 hours it was 91.67% at cut-off 10. The sensitivity of head progression distance (PD) on admission to predict the mode of delivery was 66.67% at cut-off 44mm, after 1 hour it was 75% at cut-off 51mm and after 2 hours it was 91.67% at cut-off 63mm. Conclusion: Head progression distance (PD) measurement using intrapartum transperineal ultrasound (TPUS) is correlated with Bishop score using digital examination. The increasing PD with progress of labor is associated with more likelihood of vaginal delivery. PD can be used for objective assessment of progress of labor.
{"title":"Correlation Between the Head Progression Distance Using Intrapartum Transperineal Ultrasound and the Bishop Score Using Digital Examination in Assessment of Labor Progress","authors":"A. el-habashy","doi":"10.21608/ebwhj.2022.58189.1118","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.58189.1118","url":null,"abstract":"Aim: Evaluation of the role of head progression distance (PD) using the transperineal ultrasound (TPUS) in assessment of progress of labor. Materials and Methods: This study conducted on 60 cases admitted to El-Shatby Maternity University Hospital in active phase of labor, at full term with singleton pregnancy presented by vertex. We measured the head progression distance (PD) in each case on admission, after 1 hour and after 2 hours (using transperineal ultrasound) and correlated it with the Bishop score by digital examination. We documented also the mode of delivery in all cases. Results: The mean head progression distance (PD) had a statistically significant association with the fetal head station on admission, after 1 hour and after 2 hours. HPD will get longer with the progress of labor with the fetal head descent. The sensitivity of Bishop score on admission to predict the mode of delivery was 58.33% at cut-off 7, after 1 hour it was 75% at cut-off 9 and after 2 hours it was 91.67% at cut-off 10. The sensitivity of head progression distance (PD) on admission to predict the mode of delivery was 66.67% at cut-off 44mm, after 1 hour it was 75% at cut-off 51mm and after 2 hours it was 91.67% at cut-off 63mm. Conclusion: Head progression distance (PD) measurement using intrapartum transperineal ultrasound (TPUS) is correlated with Bishop score using digital examination. The increasing PD with progress of labor is associated with more likelihood of vaginal delivery. PD can be used for objective assessment of progress of labor.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89235848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.139884.1176
Ibrahim Mohamed, A. Sobh, A. Kamel, S. Mostafa, D. Habib, A. Yousef
Aim: To investigate the pregnancy rate in women with normal uterine cavity and those with previously corrected uterine cavitary lesions, assessed by hysteroscopy in ICSI cycles. Study Design: A prospective cohort study . Materials and Methods: The study included women undergoing ICSI cycles. Patients were allocated into two groups, patients with normal uterine cavity (group 1, n=122) and patients with previously corrected uterine cavitary lesions (group 2, n=122). Office hysteroscopy was performed post-menstrual. The main outcome measure was clinical pregnancy rate. Secondary outcomes were the implantation rate and the take home baby rate. Results: In both groups the mean±SD of the total amount of gonadotrophins used, duration of stimulation, peak estradiol level, endometrial thickness and number of mature follicles, the implantation rate there was not statistically significant different in both groups (2.22 ± 0.84 vs. 2.46 ± 0.95, p =0.419). Also, the pregnancy rate showed no statistically significant difference between both groups (33.6% vs. 23.8%, p =0.089). Conclusion: Correction of uterine cavitary lesions makes the implantation rate and pregnancy rate to be comparable to women with normal uterine cavity.
目的:探讨ICSI周期宫腔镜下子宫腔正常和子宫腔病变矫正后的妊娠率。研究设计:前瞻性队列研究。材料和方法:该研究包括接受ICSI周期的妇女。将患者分为正常子宫腔患者(1组，n=122)和既往子宫腔病变矫正患者(2组，n=122)两组。经后宫腔镜检查。主要结局指标为临床妊娠率。次要结果是着床率和带回家婴儿率。结果:两组促性腺激素总用量、刺激时间、雌二醇峰值水平、子宫内膜厚度、成熟卵泡数、着床率的平均值±SD(2.22±0.84∶2.46±0.95,p =0.419)比较，差异无统计学意义。两组妊娠率差异无统计学意义(33.6% vs. 23.8%， p =0.089)。结论:子宫腔病变的矫正使子宫着床率和妊娠率与子宫腔正常的妇女相当。
{"title":"Pregnancy Rate in Women with Normal Uterine Cavity and those with Corrected Uterine Cavitary Lesions in ICSI Cycles","authors":"Ibrahim Mohamed, A. Sobh, A. Kamel, S. Mostafa, D. Habib, A. Yousef","doi":"10.21608/ebwhj.2022.139884.1176","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.139884.1176","url":null,"abstract":"Aim: To investigate the pregnancy rate in women with normal uterine cavity and those with previously corrected uterine cavitary lesions, assessed by hysteroscopy in ICSI cycles. Study Design: A prospective cohort study . Materials and Methods: The study included women undergoing ICSI cycles. Patients were allocated into two groups, patients with normal uterine cavity (group 1, n=122) and patients with previously corrected uterine cavitary lesions (group 2, n=122). Office hysteroscopy was performed post-menstrual. The main outcome measure was clinical pregnancy rate. Secondary outcomes were the implantation rate and the take home baby rate. Results: In both groups the mean±SD of the total amount of gonadotrophins used, duration of stimulation, peak estradiol level, endometrial thickness and number of mature follicles, the implantation rate there was not statistically significant different in both groups (2.22 ± 0.84 vs. 2.46 ± 0.95, p =0.419). Also, the pregnancy rate showed no statistically significant difference between both groups (33.6% vs. 23.8%, p =0.089). Conclusion: Correction of uterine cavitary lesions makes the implantation rate and pregnancy rate to be comparable to women with normal uterine cavity.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"191 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75813760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.43299.1110
Hager Elbasiony, A. Saad, Z. Sanad
Aim: To detect changes that occurs on uterine position after cesarean section on transvaginal ultrasound examination. Materials and Methods: This case control study was carried out on (216) patients during the period from2018, till 2020. The series was analyzed in three groups: patients who underwent cesareandelivery, patients who were parous but had not undergone cesarean delivery, and patientswho were nulliparous.The axis of the uterus was determined on the transvaginal ultrasound. The uterine axis was categorized as anteverted, anteverted anteflexed, retroverted, retroverted retroflexed, anteverted retroflexed, retroverted anteflexed, and axial. Result: The anteverted retroflexed uterine position was common after CD (29.1% of CD group), rare in parous group (1.3%) and was not seen in nulliparous group. The higher number of anteverted retroflexed uteri in the CD group was statistically significant ( p ≤ 0.001) Conclusion: CD was associated with significant changes in position of uterus whichcan change the uterine flexion angle to a more retroflexedposition.
{"title":"Ultrasound Evaluation of Changes in Uterine Position after Cesarean Delivery","authors":"Hager Elbasiony, A. Saad, Z. Sanad","doi":"10.21608/ebwhj.2022.43299.1110","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.43299.1110","url":null,"abstract":"Aim: To detect changes that occurs on uterine position after cesarean section on transvaginal ultrasound examination. Materials and Methods: This case control study was carried out on (216) patients during the period from2018, till 2020. The series was analyzed in three groups: patients who underwent cesareandelivery, patients who were parous but had not undergone cesarean delivery, and patientswho were nulliparous.The axis of the uterus was determined on the transvaginal ultrasound. The uterine axis was categorized as anteverted, anteverted anteflexed, retroverted, retroverted retroflexed, anteverted retroflexed, retroverted anteflexed, and axial. Result: The anteverted retroflexed uterine position was common after CD (29.1% of CD group), rare in parous group (1.3%) and was not seen in nulliparous group. The higher number of anteverted retroflexed uteri in the CD group was statistically significant ( p ≤ 0.001) Conclusion: CD was associated with significant changes in position of uterus whichcan change the uterine flexion angle to a more retroflexedposition.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87875386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.143318.1179
A. Galal, mohamed mehesen, Ahmad Etman, M. Elmohamady
Aim: To compare classic embryo transfer versus sheath in techniques of embryo transfer. Study Design: Retrospective case control. Materials and Methods: Retrospective case control that was conducted in Multicenter fertility centers. Four thousands one hundred and fifteen infertile women undergoing ICSI with 3110 underwent fresh embryo transfer and 1005 underwent frozen embryo transfer. Sheath in technique conducted by confident positioning of the outer sheath before introducing embryo loaded inner sheath while classic technique both catheters introduced simultaneously. Primary outcomes Clinical pregnancy rate (defined as the presence of pulsating fetal heart after 6-8 weeks of Embryo transfer) in both groups. Results: A total of 3110 embryo transfer were evaluated. in 1767 (56.8% ) classic embryo transfer method was used compared to 1343 (42.2% ) sheath in .The overall pregnancy rate is 50.8 % being 52.5 % within classic embryo transfer compared to 48.6 % within sheath in transfer that was statistically significant. Sheath in embryo transfer yield 51% pregnancy rate in non-difficult embryo transfer ( comparable to classic transfer ) and yield 43.3 % in difficult cases compared to failure of transfer with classic type .Pregnancy rate i8n frozen embryo transfer was significantly higher in sheath in group versus classic transfer (60.6 % versus 52.9%). Conclusion: Sheath in Embryo transfer is a valid technique yield comparable pregnancy rate in non-complicated cases and non-comparable higher pregnancy rate in difficult cases .it is simple a traumatic techniques easy to be standardized
{"title":"Sheath in Embryo Transfer. A Step Towards Improving Pregnancy Rate in ICSI Cycles","authors":"A. Galal, mohamed mehesen, Ahmad Etman, M. Elmohamady","doi":"10.21608/ebwhj.2022.143318.1179","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.143318.1179","url":null,"abstract":"Aim: To compare classic embryo transfer versus sheath in techniques of embryo transfer. Study Design: Retrospective case control. Materials and Methods: Retrospective case control that was conducted in Multicenter fertility centers. Four thousands one hundred and fifteen infertile women undergoing ICSI with 3110 underwent fresh embryo transfer and 1005 underwent frozen embryo transfer. Sheath in technique conducted by confident positioning of the outer sheath before introducing embryo loaded inner sheath while classic technique both catheters introduced simultaneously. Primary outcomes Clinical pregnancy rate (defined as the presence of pulsating fetal heart after 6-8 weeks of Embryo transfer) in both groups. Results: A total of 3110 embryo transfer were evaluated. in 1767 (56.8% ) classic embryo transfer method was used compared to 1343 (42.2% ) sheath in .The overall pregnancy rate is 50.8 % being 52.5 % within classic embryo transfer compared to 48.6 % within sheath in transfer that was statistically significant. Sheath in embryo transfer yield 51% pregnancy rate in non-difficult embryo transfer ( comparable to classic transfer ) and yield 43.3 % in difficult cases compared to failure of transfer with classic type .Pregnancy rate i8n frozen embryo transfer was significantly higher in sheath in group versus classic transfer (60.6 % versus 52.9%). Conclusion: Sheath in Embryo transfer is a valid technique yield comparable pregnancy rate in non-complicated cases and non-comparable higher pregnancy rate in difficult cases .it is simple a traumatic techniques easy to be standardized","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"483 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79253727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.130534.1175
Yasuho Yanagihara, A. Tanaka, M. Nagayoshi, I. Tanaka, M. Ohno, A. Itakura
Aim: To determine if the properly timed, combined used of Letrozole, Cabergoline and GnRH antagonist eliminate the occurrence of ovarian hyper stimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS)? Study Design: We compared the severity of OHSS after using a new treatment with the severity of OHSS in a group of PCOS patients who received the GnRH antagonist-GnRH agonist- based controlled ovarian stimulation (COS) in retrospective cohort study between August 2019 and December 2021. Materials and Methods: 53 PCOS patients received the new treatment were compared to 32 PCOS patients treated with conventional methods. 5mg of Letrozole, 0.5mg of Cabergoline and 0.25mg of GnRH antagonist were administered from just after the oocyte pick up (OPU) for five consecutive days. Results: There were no significant differences in the clinical pregnancy rate, cumulative pregnancy rate and cumulative live birth rate between the two COS. The number of days between OPU and menstruation start in the novel COS was significantly lower than that of the conventional one (5.26+2.59 vs. 17.62+5.75). This treatment produced no incidences of OHSS, compared to 21.9% of all cases having mild OHSS with the conventional method. Conclusion: We found that administering Letrozole, Cabergoline and GnRH antagonist for five days consecutively after OPU effective for the complete prevention of OHSS.
目的:探讨来曲唑、卡麦角林和GnRH拮抗剂合用是否能消除多囊卵巢综合征(PCOS)患者卵巢过度刺激综合征(OHSS)的发生?研究设计:在2019年8月至2021年12月的回顾性队列研究中，我们比较了一组接受GnRH拮抗剂-GnRH激动剂控制卵巢刺激(COS)治疗的PCOS患者在使用新疗法后的OHSS严重程度与OHSS严重程度。材料与方法:将53例PCOS患者与32例常规治疗的PCOS患者进行比较。来曲唑5mg，卡麦角林0.5mg, GnRH拮抗剂0.25mg，从卵母细胞取卵(OPU)后开始连续5天。结果:两组患者临床妊娠率、累计妊娠率、累计活产率差异均无统计学意义。新型COS组OPU与月经开始间隔天数明显低于常规COS组(5.26+2.59 vs. 17.62+5.75)。与21.9%的常规方法的轻度OHSS相比，这种治疗方法没有产生OHSS。结论:OPU后连续5天给予来曲唑、卡麦角林和GnRH拮抗剂可有效预防OHSS。
{"title":"Combined use of Letrozole, Cabergoline and GnRH antagonist Eliminates Ovarian Hyperstimulation Syndrome (OHSS) in Polycystic Ovarian Syndrome (PCOS)","authors":"Yasuho Yanagihara, A. Tanaka, M. Nagayoshi, I. Tanaka, M. Ohno, A. Itakura","doi":"10.21608/ebwhj.2022.130534.1175","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.130534.1175","url":null,"abstract":"Aim: To determine if the properly timed, combined used of Letrozole, Cabergoline and GnRH antagonist eliminate the occurrence of ovarian hyper stimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS)? Study Design: We compared the severity of OHSS after using a new treatment with the severity of OHSS in a group of PCOS patients who received the GnRH antagonist-GnRH agonist- based controlled ovarian stimulation (COS) in retrospective cohort study between August 2019 and December 2021. Materials and Methods: 53 PCOS patients received the new treatment were compared to 32 PCOS patients treated with conventional methods. 5mg of Letrozole, 0.5mg of Cabergoline and 0.25mg of GnRH antagonist were administered from just after the oocyte pick up (OPU) for five consecutive days. Results: There were no significant differences in the clinical pregnancy rate, cumulative pregnancy rate and cumulative live birth rate between the two COS. The number of days between OPU and menstruation start in the novel COS was significantly lower than that of the conventional one (5.26+2.59 vs. 17.62+5.75). This treatment produced no incidences of OHSS, compared to 21.9% of all cases having mild OHSS with the conventional method. Conclusion: We found that administering Letrozole, Cabergoline and GnRH antagonist for five days consecutively after OPU effective for the complete prevention of OHSS.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88184784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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